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TUTCRIS

Overdiagnosis and overtreatment of prostate cancer

Tutkimustuotosvertaisarvioitu

Standard

Overdiagnosis and overtreatment of prostate cancer. / Loeb, Stacy; Bjurlin, Marc A.; Nicholson, Joseph; Tammela, Teuvo L.; Penson, David F.; Carter, H. Ballentine; Carroll, Peter; Etzioni, Ruth.

julkaisussa: European Urology, Vuosikerta 65, Nro 6, 2014, s. 1046-1055.

Tutkimustuotosvertaisarvioitu

Harvard

Loeb, S, Bjurlin, MA, Nicholson, J, Tammela, TL, Penson, DF, Carter, HB, Carroll, P & Etzioni, R 2014, 'Overdiagnosis and overtreatment of prostate cancer', European Urology, Vuosikerta. 65, Nro 6, Sivut 1046-1055. https://doi.org/10.1016/j.eururo.2013.12.062

APA

Loeb, S., Bjurlin, M. A., Nicholson, J., Tammela, T. L., Penson, D. F., Carter, H. B., ... Etzioni, R. (2014). Overdiagnosis and overtreatment of prostate cancer. European Urology, 65(6), 1046-1055. https://doi.org/10.1016/j.eururo.2013.12.062

Vancouver

Loeb S, Bjurlin MA, Nicholson J, Tammela TL, Penson DF, Carter HB et al. Overdiagnosis and overtreatment of prostate cancer. European Urology. 2014;65(6):1046-1055. https://doi.org/10.1016/j.eururo.2013.12.062

Author

Loeb, Stacy ; Bjurlin, Marc A. ; Nicholson, Joseph ; Tammela, Teuvo L. ; Penson, David F. ; Carter, H. Ballentine ; Carroll, Peter ; Etzioni, Ruth. / Overdiagnosis and overtreatment of prostate cancer. Julkaisussa: European Urology. 2014 ; Vuosikerta 65, Nro 6. Sivut 1046-1055.

Bibtex - Lataa

@article{487a6be147ef48fa990a14fb4ab12efd,
title = "Overdiagnosis and overtreatment of prostate cancer",
abstract = "Context Although prostate cancer (PCa) screening reduces the incidence of advanced disease and mortality, trade-offs include overdiagnosis and resultant overtreatment. Objective To review primary data on PCa overdiagnosis and overtreatment. Evidence acquisition Electronic searches were conducted in Cochrane Central Register of Controlled Trials, PubMed, and Embase from inception to July 2013 for original articles on PCa overdiagnosis and overtreatment. Supplemental articles were identified through hand searches. Evidence synthesis The lead-time and excess-incidence approaches are the main ways used to estimate overdiagnosis in epidemiological studies, with estimates varying widely. The estimated number of PCa cases needed to be diagnosed to save a life has ranged from 48 down to 5 with increasing follow-up. In clinical studies, generally lower rates of overdiagnosis have been reported based on the frequency of low-grade minimal tumors at radical prostatectomy (1.7-46.8{\%}). Autopsy studies have reported PCa in 18.5-38.5{\%}, although not all are low grade or low volume. Factors influencing overdiagnosis include the study population, screening protocol, and background incidence, limiting generalizability between settings. Reported rates of overtreatment vary widely in the literature, although contemporary international studies suggest increasing use of conservative management. Conclusions Epidemiological, clinical, and autopsy studies have been used to examine PCa overdiagnosis, with estimates ranging widely from 1.7{\%} to 67{\%}. Correspondingly, estimates of overtreatment vary widely based on patient features and may be declining internationally. Careful patient selection for screening and reducing overtreatment are important to preserve the benefits and reduce the downstream harms of prostate-specific antigen testing. Because all of these estimates are extremely population and context specific, this must be considered when using these data to inform policy. Patient summary Screening reduces spread and death from prostate cancer (PCa) but overdiagnoses some low-risk tumors that may not have caused harm. Because treatment has potential side effects, it is critical that not all patients with PCa receive aggressive treatment.",
keywords = "Overdiagnosis, Overtreatment, Prostate cancer, Prostate-specific antigen, Screening",
author = "Stacy Loeb and Bjurlin, {Marc A.} and Joseph Nicholson and Tammela, {Teuvo L.} and Penson, {David F.} and Carter, {H. Ballentine} and Peter Carroll and Ruth Etzioni",
year = "2014",
doi = "10.1016/j.eururo.2013.12.062",
language = "English",
volume = "65",
pages = "1046--1055",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "6",

}

RIS (suitable for import to EndNote) - Lataa

TY - JOUR

T1 - Overdiagnosis and overtreatment of prostate cancer

AU - Loeb, Stacy

AU - Bjurlin, Marc A.

AU - Nicholson, Joseph

AU - Tammela, Teuvo L.

AU - Penson, David F.

AU - Carter, H. Ballentine

AU - Carroll, Peter

AU - Etzioni, Ruth

PY - 2014

Y1 - 2014

N2 - Context Although prostate cancer (PCa) screening reduces the incidence of advanced disease and mortality, trade-offs include overdiagnosis and resultant overtreatment. Objective To review primary data on PCa overdiagnosis and overtreatment. Evidence acquisition Electronic searches were conducted in Cochrane Central Register of Controlled Trials, PubMed, and Embase from inception to July 2013 for original articles on PCa overdiagnosis and overtreatment. Supplemental articles were identified through hand searches. Evidence synthesis The lead-time and excess-incidence approaches are the main ways used to estimate overdiagnosis in epidemiological studies, with estimates varying widely. The estimated number of PCa cases needed to be diagnosed to save a life has ranged from 48 down to 5 with increasing follow-up. In clinical studies, generally lower rates of overdiagnosis have been reported based on the frequency of low-grade minimal tumors at radical prostatectomy (1.7-46.8%). Autopsy studies have reported PCa in 18.5-38.5%, although not all are low grade or low volume. Factors influencing overdiagnosis include the study population, screening protocol, and background incidence, limiting generalizability between settings. Reported rates of overtreatment vary widely in the literature, although contemporary international studies suggest increasing use of conservative management. Conclusions Epidemiological, clinical, and autopsy studies have been used to examine PCa overdiagnosis, with estimates ranging widely from 1.7% to 67%. Correspondingly, estimates of overtreatment vary widely based on patient features and may be declining internationally. Careful patient selection for screening and reducing overtreatment are important to preserve the benefits and reduce the downstream harms of prostate-specific antigen testing. Because all of these estimates are extremely population and context specific, this must be considered when using these data to inform policy. Patient summary Screening reduces spread and death from prostate cancer (PCa) but overdiagnoses some low-risk tumors that may not have caused harm. Because treatment has potential side effects, it is critical that not all patients with PCa receive aggressive treatment.

AB - Context Although prostate cancer (PCa) screening reduces the incidence of advanced disease and mortality, trade-offs include overdiagnosis and resultant overtreatment. Objective To review primary data on PCa overdiagnosis and overtreatment. Evidence acquisition Electronic searches were conducted in Cochrane Central Register of Controlled Trials, PubMed, and Embase from inception to July 2013 for original articles on PCa overdiagnosis and overtreatment. Supplemental articles were identified through hand searches. Evidence synthesis The lead-time and excess-incidence approaches are the main ways used to estimate overdiagnosis in epidemiological studies, with estimates varying widely. The estimated number of PCa cases needed to be diagnosed to save a life has ranged from 48 down to 5 with increasing follow-up. In clinical studies, generally lower rates of overdiagnosis have been reported based on the frequency of low-grade minimal tumors at radical prostatectomy (1.7-46.8%). Autopsy studies have reported PCa in 18.5-38.5%, although not all are low grade or low volume. Factors influencing overdiagnosis include the study population, screening protocol, and background incidence, limiting generalizability between settings. Reported rates of overtreatment vary widely in the literature, although contemporary international studies suggest increasing use of conservative management. Conclusions Epidemiological, clinical, and autopsy studies have been used to examine PCa overdiagnosis, with estimates ranging widely from 1.7% to 67%. Correspondingly, estimates of overtreatment vary widely based on patient features and may be declining internationally. Careful patient selection for screening and reducing overtreatment are important to preserve the benefits and reduce the downstream harms of prostate-specific antigen testing. Because all of these estimates are extremely population and context specific, this must be considered when using these data to inform policy. Patient summary Screening reduces spread and death from prostate cancer (PCa) but overdiagnoses some low-risk tumors that may not have caused harm. Because treatment has potential side effects, it is critical that not all patients with PCa receive aggressive treatment.

KW - Overdiagnosis

KW - Overtreatment

KW - Prostate cancer

KW - Prostate-specific antigen

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=84899559783&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2013.12.062

DO - 10.1016/j.eururo.2013.12.062

M3 - Review Article

VL - 65

SP - 1046

EP - 1055

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 6

ER -